Kornimate/medical-research-clean huggingface dataset:
efficacy of cefepime continuous infusion versus an intermittent dosing regimen

Conditions: Sepsis; Bacteremia

Summary: to determine the efficacy of the administration of 7 to 14 days of cefepime in a continuous infusion vs an intermittent (every 8 hours) administration, in adult patients hospitalized in bogotá with sepsis and bacteremia caused by gram negative bacilli. the outcome was the rate of clinical cure and microbiological cure after 7 and 14 days of initiation of therapy and rates of relapse after 28 days. hypothesis: the administration of beta lactams in continuous infusion allows a clinical or microbiological cure greater than the intermittent administration.


Eligibility criteria:
inclusion criteria: * patients with sepsis, severe sepsis o septic shock diagnosis hospitalized in intensive care unit. * presence or suspect of gram negative bacilli bacteremia * to be possible the follow up according to planned visits * patients should be venous access to administrate the antibiotic * patients, whom the physicians consider cefepime like election treatment exclusion criteria: * patients with a high degree of immunosuppression defined by: * the presence of neutropenia (neutrophils count less than 500 cells/ml, or infection with hiv-aids with count of less than 50 cd4 cells/ml, or chronic administration of immunosuppressive drugs (prednisone more than 5 mg/per day, azathioprine, cyclophosphamide, mycophenolate mofetil, etc.) * patients with chronic renal failure. * pregnant female patients * patients in whom to approach the doctor is considered with a high probability of dying in the next 48 hours (e.g. multiorgan system failure with more than 5 organs engaged according to the criteria of marshall et al. or shock irreversible. * patients with chronic infections as osteomyelitis or have prosthesis that would perpetuate the infection and requiring the administration of antibiotics for an extended time (including endocarditis). -patients with mixed infections that include gram positive microorganisms or fungal infections. * -patients who have received in the past 30 days cefepime. * patients with presence of a gram negative bacillus resistant to cefepime. -patients who are not able to identify them a bacillus gram negative. * patients who they are not able to confirm the antibiotic susceptibility of gram negative bacillus. -patients with concomitant with antimicrobial activity for gram negative bacilli (e.g. fluoroquinolones, aminoglycosides, etc.) * patients who have known hypersensitivity to b lactams or cefepime

Keywords: sepsis bacteremia intravenous infusions cefepime
measuring impact of computer gaming on arm use in rett syndrome

Conditions: Rett Syndrome

Summary: using a tele-research approach, we will recruit, enroll, guide and support carers and participants to engage in computer based activities (modified virtual reality) with the primary outcome of reducing stereotypies and increasing independent arm and hand use and secondary outcome of improving quality of living. because of our virtual approach, we are able to recruit from multiple countries and all states and territories of the usa.

early in life, individuals with rett syndrome lose purposeful use of their hands and engage in handwringing and handmouthing stereotypies. it is important to pursue interventions that may facilitate the development and sustained use of arms/hands for productive involvement in daily needs that ultimately improve quality of life. investigators plan to use a tele-research approach to assist caregivers and the participants in playing customized computer generated games that require independent and sustained hand separations and initiated and sustained movement patterns to control the modified virtual reality activity that serves as our intervention. customization of the games and activities used will require collaboration with the caregivers of each participant to ensure that the level of motivation and interest of the participant matches the game/activities used. brightly colored wristbands will be worn on each participant's wrist during the one-hour long intervention in which they will be involved 3 days per week for \~12 weeks. these wrist bands will be detected by the software we developed. as the participants move their arms, our software will detect these position changes and activate the computer-based activities. at 5 different points in the study investigators will test for changes in independent reaching abilities that may result from exposure to the intervention. specifically, investigators will assess the impact of the intervention on minimizing hand stereotypies and improving the amount and quality of independent arm function. at the start and end of the study, investigators will also assess the impact the intervention had on activities of daily living, and therefore quality of life, via three goals developed in collaboration with the family/caregiver of the participant. due to the virtual nature (tele-research) of the study, investigators aim to recruit 10-12 participants from multiple countries. once enrolled, each participant will remain involved for up to 5-6 months. since all activities are hand selected for each participant in collaboration with the caregivers, risks of involvement in this study are low. investigators anticipate that this intervention will improve motor planning abilities for arm use and reduce stereotypies.

Eligibility criteria:
inclusion criteria: * rett syndrome, * understanding of cause and effect, * functional range of motion of arms to complete the movements needed to control the games. exclusion criteria: * no competing orthopedic or neuromuscular diagnosis that impacts shoulder movements

Keywords: enrichment sensory stimulation motor recovery upper extremity function
sensory symptoms in tourette syndrome and obsessive-compulsive disorder

Conditions: Tourette Syndrome; Obsessive-Compulsive Disorder; Sensory Disorders

Summary: this study seeks to address two key questions related to sensory dysregulation in tourette syndrome (ts) and obsessive compulsive disorder (ocd): 1) is sensory dysregulation in ocd clinically distinct from that in ts? 2) to what extent does sensory dysregulation affect qol in each of these disorders? patients with ts, patients with ocd, and healthy controls will complete an online battery of validated questionnaires assessing sensory dysregulation, psychiatric symptoms, and quality of life.

tourette syndrome (ts) is a neurodevelopmental disorder affecting 1% of school-aged children, with one-third of patients suffering persistent tics into adulthood. obsessive-compulsive disorder (ocd) is a common comorbidity with ts. individuals with either ts or ocd frequently exhibit sensory dysregulation, manifesting as heightened awareness of internal and external stimuli. for patients with ocd, sensory dysregulation has been linked to obsessive-compulsive symptoms and is an important consideration in treatment strategies. sensory dysregulation remains largely unexplored in ts, but preliminary data suggests it is dissociable from tics, linked with obsessive-compulsive symptoms, and associated with poorer quality of life (qol). this study seeks to address two key questions related to sensory dysregulation in ts and ocd: 1) is sensory dysregulation in ocd clinically distinct from that in ts? 2) to what extent does sensory dysregulation affect qol in each of these disorders? to do so, we will recruit patients with ts, patients with ocd, and healthy controls to complete an online battery of validated questionnaires assessing sensory dysregulation, psychiatric symptoms, and qol. addressing these knowledge gaps will enhance our understanding of bothersome sensory symptoms in ts and ocd, shed light on clinical overlap and/or distinctions between these commonly co-occurring psychiatric diagnoses, and clarify qol impact and the potential need for more direct targeting of these symptoms.

Eligibility criteria:
inclusion criteria for the patient groups: * age 18 years or older * previous diagnosis of tourette syndrome and/or obsessive compulsive disorder exclusion criteria for the patient groups: - none inclusion criteria for healthy controls includes: - 18 years of age or older exclusion criteria for the patient groups: - history of any neurologic or psychiatric diagnoses

Keywords: sensory dysregulation sensory gating dysfunction tic obsessive compulsive sensory symptom
study to evaluate safety, tolerability, maximum tolerated dose (mtd), efficacy, and pharmacokinetics (pks) of cpi-613 given twice weekly for three consecutive weeks in patients with advanced hematologic malignancies

Conditions: Advanced Hematologic Malignancies

Summary: chemotherapy resistance is a major cause of death in patients with advanced hematologic malignancies. the proposed novel mechanism of action, non-cross resistance with chemotherapeutic agents currently used in the clinic, and lack of cpi-613-related myelosuppression preclinically and clinically to date make cpi-613 a suitable candidate for phase i clinical trial in these patients. the current trial is one of several clinical trials of cpi-613. other clinical trials that are conducted in patients with solid tumors have already been initiated. the primary objective of this study is to determine the safety and mtd of cpi-613 when administered 2x weekly for 3 consecutive weeks. the secondary objective is to determine the pks of cpi-613 following iv administration and to observe the anti-tumor effects of cpi-613, if any occur.


Eligibility criteria:
inclusion criteria: * histologically or cytologically documented relapsed and/or refractory hematologic malignancy * karnofsky performance status (kps) of \>70%. * must be ≥18 years of age. * expected survival \>1 month. * women of child-bearing potential must use accepted contraceptive methods * no radiotherapy, treatment with cytotoxic agents (except cpi-613), treatment with biologic agents or any anti-cancer therapy within the 3 weeks prior to treatment with cpi-613. exclusion criteria: * serious medical illness, such as significant cardiac disease (e.g. symptomatic congestive heart failure, unstable angina pectoris, myocardial infarction within the past 6 months, uncontrolled cardiac arrhythmia, or new york heart association class iii or iv), or severe debilitating pulmonary disease, that would potentially increase patients' risk for toxicity. * patients with active central nervous system (cns) or epidural tumor. * any active uncontrolled bleeding, and any patients with a bleeding diathesis (e.g., active peptic ulcer disease). * pregnant women, or women of child-bearing potential not using reliable means of contraception. * lactating females because the potential of excretion of cpi-613 into breast milk. * life expectancy less than 1 month. * any condition or abnormality which may, in the opinion of the investigator, compromise the safety of patients.

Keywords: acute myeloid leukemia acute lymphoblastic leukemia multiple myeloma chronic myeloid\ leukemia in blast phase
enhanced sexhealth intervention to improve adolescent outcomes

Conditions: Sexually Transmitted Diseases; Reproductive Behavior

Summary: this is an adaptive trial with an initial formative revision process followed by a randomized controlled trial (rct). up to 500 adolescents will be consented into this study to achieve 6 completed subjects for the formative process and 86 completed subjects for the rct.

in a randomized controlled trial at a pediatric emergency department, sexually active adolescents will receive the control (i.e., printed materials) or intervention (i.e., motivationally-guided facilitation) arm delivered by a health educator. the tablet-based, interactive intervention includes motivational techniques to promote risk reduction, condom skills training, and tailored service recommendations. the primary outcome is uptake of ≥1 service at the index visit (i.e., counseling, condoms, emergency contraception for immediate or future use, pregnancy/sexually transmitted infection (sti)/hiv testing, sti treatment, and clinic referral). we assess feasibility (i.e., intervention completion, recommendations discussed, and satisfaction). participants report sexual risk and care-seeking behaviors at 2, 4, and 6 months. we compare uptake between arms using fisher exact tests.

Eligibility criteria:
inclusion criteria: * aged 14-19 years old * reside within 30 minutes travel time * report previous sexual activity exclusion criteria: * subjects who are unable to provide consent (i.e., determined to be too ill by the ed team, have cognitive impairment due to chronic condition or acute medical concern) * subjects in police custody * subjects seeking care due to sexual assault or psychiatric emergency * subjects who do not speak english * subjects who are patients under the clinical care of a study investigator working in the ed
assessment of the effect of rectus muscle reapproximation versus non reapproximation during cs on postoperative pain

Conditions: Postoperative Pain

Summary: the aim of this study is to assess the effect of rectus muscle re-approximation by 3 interrupted simple sutures versus tighting it by 3 vertical mattress sutures during cesarean delivery on postoperative pain.

in recent years, cesarean deliveries have increased dramatically worldwide. in egypt, 52% of women give birth by cesarean section according to the 2014 demographic and health survey. despite the rising incidence of cesarean section, controversy about the optimal surgical method of cesarean section still remains. obstetricians use a variety of surgical techniques to reduce post-operative adhesions after cesarean section, such as parietal peritoneal closure and rectal muscle approximation. they believe that adhesions may result from exposure of an opened intraperitoneal cavity to the subfascial space which can be prevented by approximating the rectus muscle or closing the parietal peritoneum. in addition, rectus muscle approximation may be considered to reduce the risk of persistent rectus muscle diastasis. however, different studies showed a controversy and inconsistency in the practice of rectus muscle re-approximation among surgeons. some obstetricians agree that the rectus muscles can regain their right anatomic position by themselves and that suturing them together does not add any benefit. even though, one of their main concern against rectus muscle approximation is its potential association with increased post operative pain, hence the importance of this prospective randomized controlled study. the aim of the investigator's study is to assess the effect of rectus muscle re-approximation by 3 interrupted simple sutures versus tighting it by 3 vertical mattress sutures during cesarean delivery on postoperative pain.

Eligibility criteria:
inclusion criteria: * • primigravida * single pregnancy * term at \>37 weeks * maternal age between 18 and 35 yrs * spinal anaesthesia. * no other medical diseases. exclusion criteria: * • prior laparotomy * vertical skin incision * chronic analgesia use * allergy to opioid or nonsteroidal anti-inflammatory drugs * body mass index more than or equal to 40.
registry for study of coils in intracranial aneurysms

Conditions: Cerebral Aneurysms

Summary: the current proposal describes a post-market, clinical registry of hydrosoft, aimed at gaining robust clinical data in a large set of patients to better define the advantages, and potentially, the disadvantages of the hydrosoft, and to inform future randomized trials.

aim 1. (primary outcome) to test the hypothesis that hydrosoft coils lead to diminished rates of aneurysm recurrence relative to bare platinum coils. in order to test this hypothesis, we will compare recanalization or recurrence rates observed in this prospective registry of hydrosoft coils used as finishing coils to historical series of aneurysms treated with bare platinum coils. this registry is designed to achieve 80% power to detect a minimally clinically relevant difference in rates of recurrence between hydrosoft-treated aneurysms compared with bare platinum coils. based on recent, prospective, randomized trials assessing both bare platinum coils and hydrogel-bearing coils with 25% and 15% recurrence rates, respectively, we predict a recurrence rate of 18% for hydrosoft treated aneurysms. typically, a "minimally clinically relevant difference" is on the order of a 30% diminution in a given undesirable outcome. as such, the registry is well powered to detect this minimally clinically relevant difference (18% expected recurrence rate for hydrosoft treated coils versus 25% for the historical control group). aim 2. (secondary outcome 1) to test the hypothesis that the hydrosoft embolic coil can be placed reliably in intracranial, saccular aneurysms, even late in the embolization procedure. success of this aim is defined as ease of placement of the hydrosoft device, without need for coil removal and subsequent "finishing" with a bare platinum coil. aim 3. (secondary outcome 2) to test the hypothesis that use of the hydrosoft embolic coil is associated with risks of thromboembolism similar to that with other coil types, on the order of 3-5% or less.

Eligibility criteria:
inclusion criteria: 1. patient presenting with a ruptured or un-ruptured cerebral aneurysm appropriate for endovascular treatment as determined by the neurovascular team (neurosurgeon/neurointerventionist) 2. patient age: patients aged between 21 and 90 years will be eligible. 3. patient hunt and hess grade 0-3. 4. patient has given fully informed consent to endovascular coiling procedure or if patient cannot consent for themselves, appropriate written consent has been sought from their next of kin, or from appropriate power of attorney. 5. aneurysm 3-15mm in maximum diameter. 6. patient is willing and able to return for follow up angiography or mra between 6-18 months. 7. the patient has not been previously entered into this registry 8. the aneurysm has not previously been treated (by coiling or clipping). exclusion criteria: 1. inability to obtain informed consent. 2. medical or surgical comorbidity such that the patient's life expectancy is less than 1 year.

Keywords: aneurysm coils
study of the prognosis of infectious endocarditis (epei)

Conditions: Endocarditis Infective

Summary: infectious endocarditis (ie) is the localization and proliferation of blood-borne germs in the endocardium. it remains a complicated disease to manage due to its low incidence, diagnostic difficulties, the change in epidemiology in recent decades and high mortality rates. the annual incidence is estimated at 3-10 cases per 100,000 people. the epidemiology of ar has changed significantly in recent years due to new risk factors. indeed, the frequency of rheumatic heart disease, which was the first predisposing factor, decreased markedly in the industrialized countries, replaced by new predisposing factors: the presence of valvular prostheses or intracardiac materials (the risk of ar is multiplied by 50 compared with the general population), hemodialysis, nosocomial infections, immunosuppression, increased use of injectable treatments and, above all, an aging population with an increase in degenerative diseases such as aortic stenosis and l mitral insufficiency. the diagnosis of ia is based on duke criteria. but the clinical presentation is sometimes atypical especially in case of infection on prosthesis where the diagnosis is based mainly on the results of the blood cultures and the ultrasound data. the lesions visualized in ultrasound are: vegetations, abscesses, pseudo-aneurysms and fistulas constituting the degenerated abscess evolution, the perforation of the cusps of the native valve or the bioprosthesis giving rise to a jet of eccentric regurgitation. the evolution of endocarditis and its prognosis vary according to many factors: the type of germ responsible, the precocity of the diagnosis, the existence of a complication, the site of occurrence. these complications of endocarditis are frequent, sometimes revealing. ei is complicated by heart failure, atrioventricular conduction disorders, peri-vascular abscesses, embolic, neurological, renal and septic complications. despite improvements in diagnosis and therapeutic methods, diagnosis is sometimes difficult, management remains very complicated and morbidity and mortality remain high. studies are still needed to study the prognosis and to determine the predictive factors for hospital mortality and long-term mortality.


Eligibility criteria:
inclusion criteria: * all patients with certain infectious endocarditis according to duke's criteria, confirmed by the presence of evocative images on the transthoracic and / or transesophageal ultrasound or by the data collected on the surgical specimens. exclusion criteria: * patients with an infection not meeting the duke ie criteria.
the application of lung ultrasound in postoperative hypoxemia patients

Conditions: Hypoxemia

Summary: postoperative hypoxemia was persistent and common after surgery.rapid diagnosis and subsequent therapeutic measures must be adopted by anesthesiologists.lung ultrasound has been confirmed to be more sensitive and accurate for diagnosis of pulmonary ailment than chest radiography.the primary objective of the present study was to evaluate lung complications by bedside lung ultrasonography on patients suffered from hypoxemia after general anesthesia in the postoperative period.


Eligibility criteria:
inclusion criteria: - at least 18 years of age, hypoxemia after general anesthesia ( definded as a spo2 \<92%,greater than 30s) exclusion criteria: * covered with surgical dressings from opening thoracic and breast surgery, noncooperate from schizophrenia or delirium, a bmi higher than 40 kg/m2, unstable hemodynamics, dyspnea from residual opioids or muscle relaxants, hemoglobin of 8g/l or less, risk of bleeding, body temperature was more than 38℃ or less than 36℃
percent change in baseline bone mineral density (bmd) after parathyroidectomy in patients with primary hyperparathyroidism

Conditions: Primary Hyperparathyroidism

Summary: the primary objective of this study is to estimate the percent change in baseline bone mineral density (bmd) starting at one year after parathyroidectomy and all the following available dates in patients presenting with primary hyperparathyroidism. the secondary objective is to identify patient factors associated with change in bmd.

the research plan is for a retrospective review to be performed of a prospectively maintained parathyroid database within the department of surgical oncology at the university of texas md anderson cancer center. the patient cohort for this study consists of all patients with primary hyperparathyroidism who underwent parathyroidectomy and also had pre- and post-operative dexa studies performed. the database will be reviewed to obtain patient and disease characteristics, laboratory values, dexa imaging results, and surgical outcomes.

Eligibility criteria:
inclusion criteria: 1. the patient cohort for this study consists of all patients within the prospectively maintained parathyroid database within the department of surgical oncology at the university of texas md anderson cancer center. 2. patients with a diagnosis of primary hyperparathyroidism who underwent parathyroidectomy during the period of september 27, 1990 to december 31, 2013 were considered. 3. all patients who had a preoperative and one year post-operative dexa study over the time period will be included. exclusion criteria: n/a

Keywords: primary hyperparathyroidism parathyroidectomy bone mineral density bmd data review